Individual
MS. TRACI DAWN HAVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.T.
Contact information
Practice address
2705 VIRGINIA RIDGE RD, PHILO, OH 43771-9761
(740) 455-1648
Mailing address
2705 VIRGINIA RIDGE RD, PHILO, OH 43771-9761
(740) 455-1648
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
R2527984
OH
Other
Enumeration date
03/10/2010
Last updated
03/10/2010
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